34D1092380 CLIA NUMBER - NEUROLOGY NEURODIAGNOSTICS & PAIN CLINIC

Laboratory Demographics

CLIA Number: 34D1092380

Facility Name: NEUROLOGY NEURODIAGNOSTICS & PAIN CLINIC

Facility Address:
1414 ELLEN ST
MONROE, NC
ZIP 28112
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Facility Phone Number: 704 283-8811

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1942214242

Taxonomy: 2084N0400X - Psychiatry & Neurology
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

CLIA Record

Field Name	Field Value
CLIA Number	34D1092380
LAB Type	Physician Office
Facility Name	NEUROLOGY NEURODIAGNOSTICS & PAIN CLINIC
Street	1414 ELLEN ST
City	MONROE
State	NC
ZIP	28112
Phone	704 283-8811
CertificateType	4
CertificateEffectiveDate	11/24/2022
CertificateExpirationDate	11/23/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024